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Back to Infections Drug Index
Brand Name: Diflucan
Name: Fluconazole
Pregnancy Category C
Drug classes of Diflucan
Therapeutic actions of Diflucan
Diflucan is a highly selective inhibitor of fungal cytochrome
P-450 sterol C-14
alpha-demethylation. This decreases ergosterol synthesis which is
the principal sterol in fungal cell membranes, thus inhibiting cell
membrane formation.
Indications of Diflucan
-
Vaginal candidiasis (vaginal yeast infections due to Candida).
- Oropharyngeal and esophageal
candidiasis. In open noncomparative studies of relatively
small numbers of patients, Diflucan was also effective for the
treatment of Candida
urinary tract infections, peritonitis, and systemic Candida
infections including candidemia,
disseminated candidiasis, and pneumonia.
- Cryptococcal meningitis.
- Prophylaxis. Diflucan is also indicated to decrease the
incidence of candidiasis in patients undergoing bone marrow
transplantation who receive
cytotoxic chemotherapy and/or
radiation therapy.
Specimens for fungal culture and other relevant laboratory studies
(serology, histopathology) should be obtained prior to therapy to
isolate and identify causative organisms. Therapy may be instituted
before the results of the cultures and other laboratory studies are
known; however, once these results become available, anti-infective
therapy should be adjusted accordingly.
Contraindications/cautions of Diflucan
- hypersensitivity to Diflucan or to any of its excipients.
Caution should be used in prescribing Diflucan to patients with
hypersensitivity to other azoles.
- Concomitant adminstration with terfanidine,
cisapride or
astemizole.
- Patients with liver failure.
- Diflucan should be administered with caution to patients with
these potentially proarrhythmic conditions.
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Adverse effects
of Diflucan
- hypersensitivity to Diflucan or to any of its excipients.
Caution should be used in prescribing Diflucan to patients with
hypersensitivity to other azoles.
- Hepatic injury: Diflucan has been associated with rare cases
of serious hepatic
toxicity, including fatalities primarily in patients with serious
underlying medical
conditions. Diflucan hepatotoxicity has usually, but not always,
been reversible on discontinuation of therapy.
- Anaphylaxis: In rare cases, anaphylaxis has been reported.
- Dermatologic: Patients have rarely developed exfoliative skin
disorders during treatment with Diflucan. In patients with
serious underlying diseases (predominantly AIDS and
malignancy), these have rarely resulted in a fatal outcome. Patients
who develop rashes during treatment with Diflucan should be
monitored closely and the drug discontinued if lesions progress.
- Some azoles, including Diflucan, have been associated with
prolongation of the QT interval torsade de pointes on the
electrocardiogram. Most of these reports
involved seriously ill patients with multiple confounding risk
factors, such as structural heart disease, electrolyte abnormalities
and concomitant medications that may have been contributory.
Diflucan should be administered with caution to patients with
these potentially proarrhythmic conditions.
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